Special Study Project: Evaluation of "Community Health Worker Training Materials for Cholera Prevention and Control in Haiti" developed by CDC/MSPP after the cholera outbreak in Haiti in 2010 Open Access

Etheart, Melissa Dominique (2012)

Permanent URL: https://etd.library.emory.edu/concern/etds/rx913q50r?locale=en
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Abstract

"Evaluation of "Community Health Worker Training Materials for Cholera Prevention and Control in Haiti" developed by CDC/MSPP after the cholera outbreak in Haiti in 2010"

Over the past two centuries, seven cholera pandemics have been documented worldwide. During Ancient times cholera was found in many parts of the world but today, the disease is restrained to developing countries. The main clinical manifestation of cholera is a "rice-water" like profuse watery diarrhea that can lead to severe dehydration and death within days if untreated. The disease is spread through ingestion of contaminated food or drinking water by feces of a person infected with Vibrio cholerae. Before the introduction of cholera in Haiti in October 2010, the disease was not present in the country in over a century. Within days after the appearance of cholera symptoms, Haitian authorities isolated Vibrio cholerae from stool specimens of suspected cholera patients. The outbreak was then confirmed with other organizations to developed training materials on cholera control and prevention as a response to the outbreak. The CHW training materials are available in three languages and are widely used in Haiti. A series of evaluation activities were conducted and the resources on the CHWs education activities. Subsequently, a review process of the training resources was launched to control for errors, inconsistencies and inaccuracies. During the review process, suggestions from the evaluation activities; and inconsistencies identified in the training manual were recorded. From this evaluation, our main recommendations to CDC and MSPP are to: 1) revise CHW training manual; 2) pilot test various Haitian Creole words used to describe safe water to gather more information about the population's understanding of safe water terms; 3) conduct an in-depth comparison of CHW training manual developed published by partner institutions; and 4) compose a revision committee board to assist the communication team in the development of subsequent versions of the CHW training material. Although cholera had dramatic effect on several populations, the disease has also contributed to medical progresses and behavior changes.

Table of Contents


CHAPTER 1 - INTRODUCTION ........................................................................................................................... 1

CHAPTER 2 - LITERATURE REVIEW .................................................................................................................... 3
2.1 ORIGIN OF THE WORD CHOLERA.................................................................................................................. 3

2.2 CHOLERA PANDEMICS................................................................................................................................ 4

2.2.1 Before the cholera pandemics..................................................................................................................... 4

2.2.2 Cholera pandemics ....................................................................................................................................5

2.3 OVERVIEW OF CHOLERA ........................................................................................................................... 10

2.3.1 Molecular biology..................................................................................................................................... 10
2.3.2 Physiopathology...................................................................................................................................... 11

2.3.3 Descriptive Epidemiology .......................................................................................................................... 11

2.3.3.1 Case definition..................................................................................................................................... 11

2.3.3.2 Disease trends..................................................................................................................................... 12

2.3.3.3 Distribution.......................................................................................................................................... 13
2.3.3.4 Demographic characteristics....................................................................................................................14
2.3.3.5 Predisposed conditions........................................................................................................................... 14
2.3.3.6 Risk factors......................................................................................................................................... 15
2.3.4 Clinical manifestations.............................................................................................................................. 15
2.3.5 Diagnosis............................................................................................................................................... 16
2.3.6 Cholera control and prevention................................................................................................................... 17
2.3.7 Treatment of cholera................................................................................................................................ 19
2.4 CHOLERA IN HAITI................................................................................................................................... 20
2.5 ROLE OF COMMUNITY HEALTH WORKERS IN HAITI CHOLERA OUTBREAK......................................................... 25
CHAPTER 3 - BACKGROUND............................................................................................................................. 27
3.1 TRAINING PURPOSE AND AUDIENCE............................................................................................................ 28
3.2 TRAINING MATERIALS............................................................................................................................... 28
3.2.1 Development of training materials............................................................................................................... 28
3.2.2 Design and format of training materials........................................................................................................ 30
3.2.3 Content of training materials..................................................................................................................... 30
3.2.4 Available languages of the training materials................................................................................................ 34
3.3 TRAINING IMPLEMENTATION..................................................................................................................... 34
3.4 TRAINING EVALUATION ACTIVITIES........................................................................................................... 35
3.4.1 Evaluation Phase 1 - Focus group.............................................................................................................. 35
3.4.2 Evaluation Phase 2 - Field evaluation.......................................................................................................... 35
CHAPTER 4 - METHODS.................................................................................................................................. 38
4.1 METHODOLOGY....................................................................................................................................... 38
4.2 DELIVERABLE.......................................................................................................................................... 40
4.3 ETHICAL CONSIDERATIONS....................................................................................................................... 40
CHAPTER 5 - FINDINGS AND RECOMMENDATIONS.............................................................................................. 41
5.1 FEEDBACK RECEIVED FROM MASTER TRAINERS DURING THE FOCUS GROUP.................................................... 41
5.1.1 Design................................................................................................................................................... 41
5.1.2 Format or presentation............................................................................................................................. 43
5.1.3 Content................................................................................................................................................. 43
5.1.4 Language............................................................................................................................................... 45
5.2 COMMENTS GATHERED FROM COMMUNITY HEALTH WORKERS DURING THE FIELD EVALUATION......................... 46
5.2.1 Design................................................................................................................................................... 46
5.2.2 Format or presentation............................................................................................................................. 46
5.2.3 Content................................................................................................................................................. 46
5.2.4 Language............................................................................................................................................... 46
5.3 SUGGESTIONS MADE BY PARTNER INSTITUTIONS......................................................................................... 47
5.3.1 Design .................................................................................................................................................. 47
5.3.2 Format or presentation............................................................................................................................. 48
5.3.3 Content................................................................................................................................................. 48
5.3.4 Language............................................................................................................................................... 48
5.4 THESIS PROJECT REVIEW.......................................................................................................................... 50
5.4.1 Design................................................................................................................................................... 50
5.4.2 Format or presentation............................................................................................................................. 50
5.4.3 Content................................................................................................................................................. 53
5.4.4 Language............................................................................................................................................... 55
5.4.5 Post hoc review around the term safe water................................................................................................. 57
CHAPTER 6 - CONCLUSION............................................................................................................................. 59
REFERENCES................................................................................................................................................ 62
APPENDIX.................................................................................................................................................... 67
APPENDIX 1 - LIST OF PARTNERS INSTITUTIONS PRESENTED DURING EVALUATION ACTIVITIES.............................. 67
APPENDIX 2 - LIST OF LANGUAGE INCONSISTENCIES FOUND AROUND THE TERM "SAFE WATER"............................ 68

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Special Study Project: Evaluation of "Community Health Worker Training Materials for Cholera Prevention and Control in Haiti" developed by CDC/MSPP after the cholera outbreak in Haiti in 2010 () 2018-08-28 15:03:29 -0400

Supplemental Files

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CHW Training Manual_v2_CREOLE_Haiti_05032011.pdf () 2018-08-28 15:05:49 -0400
CHW Training Manual_v2_FRENCH_Haiti_06032011.pdf () 2018-08-28 15:07:30 -0400
CHW Training Manual_v2_ENGLISH_Haiti_05172011.pdf () 2018-08-28 15:10:14 -0400